In accordance with the invention a sleeve-glove attachment assembly is provided for protective garments used in hazardous environments such as surgical hospital settings and testing laboratories as well as garments desiring a waterproof seal at the sleeve-glove interface such as underwater diving suits, motorcycle gear, and snow skiing apparel. Also, the invention may be used at orifices of garments other than the wrist including the neck and ankles. However an immediate solution is needed in the surgical operating room setting, so reference to this application will be explained in detail.
This invention relates to the fluid barrier properties of surgical operating room personal protective equipment (PPE). The barrier properties are vital to the healthcare worker because of blood-borne infectious diseases and deadly viruses such as Hepatitis C and HIV. Conditions like Hepatitis C do not currently have vaccines and post-operation prophylaxis, often resulting in fatal consequences. The safety of the patient undergoing surgery may also become threatened if the liquid barrier garments of the caregiver are not sealed, especially at the fingers, hands, and wrists. Presently, surgical gowns and surgical gloves exist that provide safe liquid barriers as independent devices. However, the surgical glove-gown sleeve interface is the weakest link of all PPE because the glove and gown do not form a complete uniform seal, and potentially hazardous fluids such as blood and other bodily fluids are allowed to travel between the gown and the glove, eventually reaching the skin of the user. Although the materials of currently used surgical gowns and surgical gloves are fluid resistant and even fluid impermeable, the interface of the two is not. During a surgical procedure, blood may be sprayed or squirted from the patient onto the gown chest and upper arms. Due to the resistance to fluid of the gown material, the fluids tend to bead up on the gown and run or travel down the material instead of soaking through. The problem however, is that the fluids have a tendency to run or travel to the interface of the gown and glove, and may continue to travel through the interface, through channels and air pockets separating the gown and the glove, and thereby contacting the skin of the user.
In developing a solution to the glove-gown sleeve interface problem, one must understand the procedures of the operating room, constraints of the surgeons, and how PPE is donned.
PPE must not interfere with procedures performed by surgeons and their assistants. PPE should provide: maximum view of the surgeon's hands, maximum ventilation, non-limited sizing, fast time to don and remove, acceptable hoop stress/pressure at hands and wrists, and prevent penetration of infectious or undesirable fluids such as blood, urine, and other bodily fluids.
The surgeon and assistant nurses typically wear a reusable woven fabric or disposable nonwoven fabric gown. The sleeve of the surgical gown is baggy to allow free movement of the user's arms. The end of the sleeve, the stockinet, is typically manufactured with an absorbent material that performs two functions. First, the stockinet provides a comfortable layer that contacts the skin. Secondly, the stockinet is worn around the base of the hand tightly under the glove to provide a means of stabilizing the gown and glove interface during surgery. The surgical gloves are made of elastic synthetic or natural rubber latex. Other PPE includes face shields, masks, goggles, and shoe covers.
After scrubbing, the surgeon dons the surgical gown. The hands remain inside the gown sleeve while an assistant opens the glove cuff opening. The surgeon then pushes his or her hand into the glove, then immediately pushing the hand through the stockinet and into the fingers of the glove. The assistant nurse would then pull the cuff of the surgical glove proximally toward the forearm over the baggy gown sleeve material.
The potential for fluids to contact the surgeon not only exists during the surgical procedure, but also exists upon removal of the apparel. Upon removal of the gloves, the channels and any space between the glove and gown is increased, and any bodily fluids present on the gloves or gown sleeve surfaces will travel through the interface faster, eventually contacting the skin.
Efforts have been made, attempting to solve the above problems. It has been known to double glove; however double-gloving increases the stress on the wrists and still does not seal the interface. It has also been known to wear longer gloves, which extend to the elbow or further. Longer gloves however, do not seal the interface; they simply move the interface to another location, and in doing so, decrease the breathability, and maneuverability of the user's arms. It has also been known to wrap tape around the interface, however, tape may be bulky, uncomfortable, constricting, messy, and adds time to the donning procedure, and is difficult to remove.
The present invention provides an assembly which solves the above mentioned problems, sealing the gown-glove interface. Methods of making such assemblies, and methods of donning such assemblies are also provided.